Trimethoprim interference in methotrexate assays.
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Biomedical subjects
Publications and source records attributed to J L Bock.
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31P nuclear magnetic resonance spectra and enzymatic activities are compared for alkaline phosphatase (orthophosphoric-monoester phosphohydrolase (alkaline optimum), EC 3.1.3.1) species with different zinc contents. The enzyme containing two Zn2+ per protein dimer exists in two forms; one, prepared by dialysis of native enzyme, has full enzymatic activity and a 31P magnetic resonance spectrum similar to but distinguishable from that of the native enzyme containing four or more Zn2+. The other form, prepared by restoring two Zn2+ to apoenzyme, has low enzymatic activity and a 31P magnetic resonance spectrum that indicates stoichiometric binding of phosphate, but otherwise altered properties. Reconstituted enzyme with four Zn2+ is similar to but distinguishable from native enzyme with four Zn2+. Chromatography on DEAE-cellulose can separate apoenzyme and enzyme containing two Zn2+ and suggests that the binding of a pair of Zn2+ is cooperative.
Phosphate-water oxygen exchange catalyzed by Escherichia coli alkaline phosphatase was monitored using the 18O shift on the 31P NMR signal of inorganic phosphate. Different kinetic patterns were observed with native zinc enzyme and with its cobalt analogue. For native enzyme at pH values ranging from 4.4 to 10.0, the distribution of 18O species in Pi, viz. P18O4, P18O316O,P18O216O2,P18O16O3,P16O4, with time is compatible with a kinetic scheme in which E-P, the noncovalent enzyme-phosphate complex, dissociates more rapidly than it forms the covalent complex E-P. For the cobalt enzyme at pH 6.8, the distribution of 18O species in Pi with time is different and leads to the conclusion that formation of E-P is more rapid than dissociation of Pi from E-P-A computer simulation gave good quantitative agreement with the observed distribution for the time course of the cobalt enzyme reaction when the ratio of the rate of formation of E-P to dissection of E-P was assumed to be 3 +/- 0.5.
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Measurement of CK-MB and its isoforms by high-voltage electrophoresis has been proposed as a sensitive test for early detection of myocardial infarction (MI). We performed a prospective study of this test in 231 patients presenting to the Emergency Department with symptoms consistent with ischemic chest pain. Blood specimens were obtained at 0, 1, and 3 h following presentation, and plasma was immediately frozen and analyzed within 1 week by high-voltage electrophoresis for total CK-MB and isoforms. The test was considered positive whenever total CK-MB was elevated (>6 U/L) or the cardiac isoform MB2 was relatively increased (MB2 > 2 U/L and MB2/MB1 > 1.7). This test had a sensitivity of 68% overall and 55% for specimens collected within 3 h of symptom onset. It was positive within 3 h of presentation in 36/39 (92%) of patients with confirmed MI. Specificity was 92% overall and did not vary with time after symptoms. The CK-MB alone, at the cutoff of 6 U/L, had lower sensitivity overall (56%; p = 0.01) and within 3 h of onset (39%; p = 0.03), and higher specificity overall (98%; p < 0.001). Lowering the cutoff for CK-MB alone to match the sensitivity of the isoform test caused a greater loss of specificity. It is concluded that analysis of CK-MB by high-voltage electrophoresis is an effective method for rapid diagnosis of MI, with the isoform analysis enhancing early sensitivity.